Mission Lake Convalescent Center Inc.
Skilled Nursing Facility
12110 Holmes Rd, Kansas City
Missouri, 64145-1707
816-941-3006 816-942-8049
Mission Lake Convalescent Center Inc. is a Skilled Nursing Facility in Kansas City, Missouri. It is located at 12110 Holmes Rd, Kansas City and it's customer support contact number is 816-941-3006. The authorized person of Mission Lake Convalescent Center Inc. is Mr. Loren Rea who is President of this DME and his contact number is 816-941-3006. Active license number of Mission Lake Convalescent Center Inc. is 034738 for Skilled Nursing Facility in Missouri.
Mission Lake Convalescent Center Inc. is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
DME Supplier Details:
Mission Lake Convalescent Center Inc. type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Mission Lake Convalescent Center Inc. |
| Type: | Skilled Nursing Facility |
| Location: | 12110 Holmes Rd, Kansas City,
Missouri, 64145-1707 |
| Phone: | 816-941-3006 |
| Fax: | 816-942-8049 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Mr. Loren Rea |
| Position: | President |
| Contact Number: | 816-941-3006 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1770528986 |
| NPI Enumeration Date: | 19 Jun, 2006 |
| NPI Last Update On: | 19 Feb, 2013 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mission Lake Convalescent Center Inc. are as mentioned below.
| Specialization | License Number | State | Status | |
| Skilled Nursing Facility | 034738 | Missouri | Primary | |
| Nursing Facility Supplies | 032111 | Missouri | Secondary | |
| Parenteral & Enteral Nutrition | 032111 | Missouri | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 032111 | Other | Missouri | Provider |
| 1770528986 | Other | Missouri | Npi |
| 102084506 | Medicaid | Missouri | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 12110 Holmes Rd,
Kansas City, Missouri |
| Zip: | 64145-1707 |
| Phone Number: | 816-941-3006 |
| Fax Number: | 816-942-8049 |
Patients can reach Mission Lake Convalescent Center Inc. at
12110 Holmes Rd, Kansas City, Missouri or can
call on customer care at 816-941-3006.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.